107 – Menopause, testosterone & rowing the Atlantic at 50

0:00This is a really interesting podcast with two guests, Gail and Nikki, who are both phenomenal rowers. They share their journey, how they're training. One of them takes all three hormones. One of them would love to take hormones and has been refused by so many doctors. So we talk about the struggle of how to receive evidence-based hormone treatments and also the importance of taking up a new sport, including rowing over the age of 50. So enjoy. So two people on my podcast today. I feel really impressed that you've travelled so far, but you've come to talk about how you're going to travel even further rowing.

0:42So just this is incredible. You've done the row already. You're doing it soonish, starting with sponsorship. And just tell me about what you're doing. Well, we're team old enough to row better. We're a mixed team of five. We're three women and two men. We're from all over the world, actually. We've got two people from Colorado in the United States. And we have Nikki from Scotland. We have Gabe from Ireland and myself from Cheshire in England, obviously. We're all over 50. We're promoting health and fitness for the over 50s. and we're called Team Old Enough to Row Better. And where are you rowing?

1:29We are rowing the Atlantic in the world's toughest row. So we leave La Gomera next year on the 12th of December, weather permitting and heading across to Antigua. And how many miles? 3 ,000 miles, yes. 3 ,000 miles that you're rowing. Yeah. And how long is that going to take you? We would like to do it in 44 days. I would like to do it in 40 days. And last time it took us 47. So you've done it before. What a challenge. It's amazing. But you were saying scary, but amazing. And it can't be that bad. Otherwise you wouldn't be doing it again. Yeah, pretty much. It's a different feeling out there. It's just so different out there.

2:12And it's hard. You can't ever explain it unless you've done it. Just to be out in the Atlantic, the first two weeks is terrifying. But after that, it's just amazing. then the wildlife, the sunsets, all of it. It's just inspirational. Yeah. And it's great. There was a big fleet of women last year, which was really good to see. And we weren't the oldest team. There was four teams, three teams, similar to our team, which was women over 50s. So how many people do it all together? There was 44 crews last year and over 120 rowers. So, but in that there's wee races between. I mean, it is a race and in that there's wee races in between.

2:52So our team was a Welsh team and an English team and obviously the Scottish girls. So we won. You won? Yeah. Amazing. Well, between the three of us, we didn't win overall. It was a group of young boys about 20. Yeah. So that's our challenge. That's incredible. We will be the oldest mixed team to do it, hopefully. So we should set a new world record as the oldest mixed team to do this and the fastest. next year. So could you reach out to me and saying that you're taking hormones and you probably wouldn't be quite doing this without hormones? Is that fair to say? That's absolutely true. So a few years ago, when the perimenopause and menopause struck, I actually had to give up rowing.

3:41I had to give up rowing for three months because because my wrists hurt so much and my captain didn't want me to cause any damage until we knew what it was and there were lots of other symptoms that were being treated separately nobody put the big picture together and said oh you're on the menopause perhaps you should start taking estrogen or testosterone or other hormones to help ease the symptoms. So I had a bladder infection for three months. They sent tests off for that, didn't have a bladder infection. My wrists, my fingers, my knees, everything hurt. And again, it's only when I started to take estrogen and other hormones that these things started to subside.

4:34Yeah. So did it take a while before you saw someone to get you the hormones? Yes, it was actually my husband that did some research and he listened to you. Great. And he introduced me to your podcast. And that's when I made an appointment to see someone, a hormone specialist, to actually get some hormone treatment myself. Yes. And it made a massive difference straight away within a few weeks. It's incredible, isn't it? I think once you can join the dots, it's all very obvious, but medicine has become so siloed that no one looks at the bigger picture. When I trained many years ago in Manchester, I had some really great trainers and they were very much just go back to the basics, see what the common denominator is really, and listen to your patients, believe your patients, ask more questions because it's all in the history.

5:28And sometimes in medicine now, I feel like it's all tick box. You've got these set questions, set things that you need to ask, and then you forget about the rest almost. And then patients know that they're seeing a cardiologist, so they'll only talk about heart symptoms or a rheumatologist, they'll only talk about joint symptoms. And we're always pressurised when we go and see a doctor because we know that they're running out of time or whatever. So then the patients don't give the history that perhaps they would. They're not asked the questions. And you can see why it doesn't, people don't think, well what is happening throughout the whole body that's causing all these different symptoms and once you take a step back it's also obvious but at the time it's isn't and it's just frustrating that it's missed so often absolutely yeah and then obviously I started having the hot flushes at night the night sweat yes lack of sleep so that started become more obvious yeah but but nobody put all the other symptoms together that the gums the you know the the burning gum sensation nobody put all those things together and it's only when I started to take hormones that all those symptoms melted away melted away yeah so you take all three hormones so yeah I take estrogen I take testosterone I I have a Mirena coil fitted yeah which I after listening to your podcast, I now realise that's a synthetic hormone.

6:58So I'm looking at getting that changed and taking a body identical hormone. I mean, some people still have the Mirena in and then just take body identical progesterone as well, which is always an option. And if you had any more UTIs at all? Not like that, no. Yeah. And are you taking hormone treatment? Not at the minute, no. And is that because you don't want to? No. is because my journey has been an awful experience. So I started perimenopausal late. I was in my mid-50s. Started, you know, with the foggy brain, losing the car keys, just coordination not right, not sleeping. Didn't have the sweats like I get now.

7:43So I went to see my doctor. It was a really good doctor. And I think I live in Scotland, so I think it depends on the doctors that you have. had a great doctor and I must admit the male doctors apart from the last female doctor I've seen has been much better than the female doctors which I found a surprise and so he gave me a set of tablets that I took and it was a seven day break in the middle that was fine and then my body changed again and we tried a new set didn't work my thyroid was not working quite as well So they decided I needed to try a Marina Coyo. Wasn't sure about it. Had a few conversations about it.

8:21It was the worst experience of my life. I had issues having it inserted. And I had six months of just a full bleed. And in that time, I think I was a psycho. Really? So it affected your mood? Oh, I was awful. Crying constantly. Couldn't rationalize things. Arguing over things I would never argue. I don't like arguments. I was having arguments, poor concentration level. And it was just awful. And I just felt I constantly smelt awful because that's what I could smell with myself. And after a while, I managed to get that removed. And they're reluctant to remove it. So reluctant to move it, take it out.

9:01So they did take it out. And did you feel better when it was removed? Yes, instantly. Within a few days, the heavy period stopped much better. and then again you got your symptoms back so I went back to see another doctor female doctor and my partner came with me obviously symptoms were coming back foggy brain all the rest of it and the female doctor I was like walked in and she was my age group so I thought oh goody this is going to be good and really felt reassured felt easy to talk and she just rubbed my arm and I explained I had no interest in sex my sex life was out the window and just really couldn't concentrate and she rubbed my arm and told me that I was past that age and I didn't want to be doing that mucky stuff and clearly I was depressed and gave me a prescription from antidepressants.

9:50So this is you asking for hormones including testosterone and your doctor is judging about your sex being messy. Yeah I was too old for doing that mucky stuff anyway. What was your response to that? I think my jaw fell open just waiting for somebody from Beagle to pop out and, you know, be interviewed and it was all wrong. I was absolutely taken aback, sat in the car, burst into tears. I bet. Because you feel you're going mad. You really feel, you forget things. You think you've got on sorts of Alzheimer's and you just feel that you're going mad. And it was all fun. I sat in the car, cried, kept looking at my partner going, I don't feel depressed.

10:32Do you think I'm depressed? And he was absolutely not. Did you take the antidepressants? We ripped up the prescription straight away. And I had moved a dress, so I went back to, we had to move doctors. So I went back to another doctor and it was a man again and he was so good, took time to listen. It was a phone call which made it easier. So he prescribed gel and a tablet, which I was on. And then I was on that up until I was due to go on the road. But I still didn't feel, I felt a lot better, but I still didn't feel myself. I was still very teary, still very forgetful. Training-wise, I was fine.

11:16But it's just like, you know, you put your car keys down and can't remember where you've put them. So I just didn't feel myself, but I felt much better than I did. So I just put up with it. And then we went training because it was a gel and we were in the boat. Trying to store that was quite difficult. I can imagine. And then in the heat, it went like water. Yeah, so you wouldn't have absorbed it anyway. So I was like, so I went back to the doctors again, same doctor, explained it. So he gave me the patches to take away. So I started using them. But again, it just didn't feel like me. And you're like, is this me?

11:51Is this the new me? Is this what I've got to get used to? I feel all emotional. I'm going to start greeting. And you just think you do. This is what you have to just cope with. so uh so i went away trained took it away with me and then on the boat i just decided i didn't need it my days and nights were muddled up so i just left it and i felt fine and for the first time i felt much better and much brighter but then you haven't got car keys to worry about on the boat you know your jobs are so limited of course all you're doing is eating sleeping washing washing your hair and then um rowing and that's it I'm watching the navigation system and that's all you had to do and then I come across uh finished delighted up on a high and then thought I don't need hormones again this is great and then life kicks in you're back to work you're back to try training again um because I've been accepted for the lovely crew which I'm delighted about so I'm back to training again and all the symptoms are coming back and not sleeping up either two o 'clock in the morning and which is good because then maybe I fall back to sleep for four but if I'm up at four I'm up.

13:06It's relentless isn't it? Yeah it's really hard really really hard in work I work for children's services you have to be on the ball and some days I don't even know how to spell my name and it's just yeah so it's hard so I went back to the doctors got prescribed the same stuff and it's just not working no so I've just come off it but you're going to see someone else yes I've got an appointment with your clinic next week good so it's because a lot of people either don't absorb or it's not right for them and it's also having all three you've never had testosterone presumably. No we don't get that prescribed in Scotland it's not on on the NHS web page sadly.

13:46It's absolutely and I think it's got I was saying to you before we started I think it's got harder in Scotland and I don't there's lots of politics and various people behind it but it seems whenever I go to Scotland people are crying out literally for their own hormones and it is wrong it's harming women by making these decisions because testosterone is the most biologically active hormone we have as women. We produce more testosterone than estrogen when we're younger. So why is it that some people decide that testosterone is less important than the other two hormones? It doesn't make sense. And testosterone is really important for mood, energy, concentration, stamina as well.

14:26And a lot of people find that it really, like, you know, you have as well, it can really improve. And it feels so frustrating for me. I feel like I'm dangling a carrot by giving people information, but yet they can't have it. And it seems really wrong. It's different if people don't want it. Of course, they don't have to have it. But if you want to try something, then it feels really wrong. Like you were given a merinole that you didn't really want, that was a synthetic hormone, yet all you want is your natural hormone back. It's quite simplistic medicine. And you take thyroxine, don't you? Yes, I am on thyroxine.

14:58So is anyone ever worried about giving you that hormone? Absolutely not. No, not at all. It feels weird, doesn't it? And you get your blood checked every 12 months. And then obviously if there are a few problems and it starts changing, you go and see the doctor, quick blood test, and then a phone call, it needs to go up or down. And it's really strange, really strange. It's weird, isn't it? It doesn't make sense. I wanted to take a quick pause from our conversation to tell you about my new book, The Power of Hormones. Many of the topics we discuss on this podcast are explored in much greater depth in my book.

15:34I look at how hormones really work in the body, why they've been misunderstood for decades, and how confusion between natural hormones and synthetic hormones has influenced medical practice and public perception. Most importantly, I explain why understanding hormones is essential for improving both current health and future health. So if you'd like to continue learning beyond the podcast, my book, The Power of Hormones, is available now, and I've included a link to buy in the episode show notes. So, you know, I'm very interested in the history of medicine and the history of hormones. And once they decided that those hormones, progesterone and estrogen were due to periods in reproduction, the pharmaceutical companies paid the gynecologist to work with so it became like a gynecological hormones.

16:28And then once they realised testosterone could help men, it became obviously of the testes, you know, testosterone. And so then it was all a man's hormone. And it's like everyone forgot just the basics. And then when doctors started to talk more about testosterone helping with mood and energy and concentration, they thought these doctors were sham doctors and they thought it was all placebo. And these doctors were ridiculed. And it's so sad to see or hear stories about these eminent doctors just literally falling down from the medical profession because they didn't want to believe that this hormone that also helped with libido was going to help elsewhere.

17:06And we're almost coming back to that now, you know, to have to describe to a doctor about your sex life when there's a hormone that works on every cell in the body just feels really degrading. You know, I mean, don't get me wrong, I talk about sex in my consultations, but it's not the only thing I talk about, you know. And to think there's one hormone that only has effect on one symptom, that just seems really too simplistic. Our bodies don't work like that. No, absolutely not. And then when you read about it, I mean, we all need different ones, don't we? Yeah. Your body craves for different things.

17:40Of course it does. And all you're getting is a tube. Here you go, put that on, rub it up and down your arms and use a tablet. That we're all the same. Yeah, I know. We may not be. No, absolutely no. And it's such a shame. It is. And, you know, the last 10 years of specialising in hormones, I've really learnt more about the craft, really, of individualising the doses and the type and the absorption. And everyone's, you know, really different. And what people start on might mean not what they're on a bit later on. But I worry because so many women can't access hormones, the majority of women aren't getting them still.

18:13But when you talk, you've seen loads of different doctors. and some of them like you say are nice and some of them aren't so nice but actually it's irrelevant well it's not completely irrelevant whether they're nice or not but actually you want the treatment i just wonder like if you'd been given the right dose and time of a hormone treatment the first consultation you wouldn't have had to see all these other doctors and try all these different medications that's ended up not being used yeah and there was a program on the telly only last week about how much wasted medication we're actually yes doing yet they're dishing these things for you to try and if it's not right you can come back and we'll give try something else yes and when you at times you feel okay with that but other times you think i deserve more yeah because you do and i think that was for the i think talking to yourself obviously we've had conversations not knowing each other long but we're already having these conversations and hearing what a difference it's made yeah you're like well why can't i have that Yeah.

19:14Testosterone was a real game changer for me. I've described it to Nikki as the sun coming out, really. You know, that lovely feeling you get when you're sat in the sunshine and that lovely warm feeling. Because all of a sudden the mental lists that you carry suddenly become a lot easier to maintain these mental lists in your head. yeah also um just coordination yeah going back to sports yeah um so for example the example i always give is um you know part of my training is running and um there was a section on my run which i call the um the stepping stones and it was just a cobbled area and it was just you know never thought about crossing it before my feet would always go in the right place across these these cobbled stones and it was just the overflow from the canal.

20:02And then one morning I got there and I just didn't know where to put my feet at all. When I started to take testosterone, it just all came back. I just didn't need to think about it anymore. I just knew. It's interesting, isn't it? Well, I mean, our hormones work on our cerebellum, which is our balance part of our brain. It's that bit at the bottom really, and also help with proprioception. so just that feeling you know we take it for granted don't we we put our feet down and we know whether it's a carpet or a stone underneath us without looking and that often goes or isn't so good and the signals aren't so good and so the firing of the of the nerves the pathways don't fire as quickly without hormones as well and then the signals to the brain even when they get there they can't process them in the same way and we know we've known this for decades how the hormones work.

20:52So it's not just a placebo or a coincidence. And, you know, we see a lot of people find that they get more bruising down their legs or their arms because they're slipping and falling a bit more, a bit like being adolescent again, really, again, because those hormones aren't there. But it just feels weird because when this person gave you antidepressants, I know you didn't take them. Did they talk to you about the potential risks and side effects of antidepressants? No, I was just handed a prescription. Yeah, you see, I find that really confusing because lots of people talk about the lack of evidence for hormone treatments.

21:27And part of that is because the studies haven't been done. And the studies that were done were on synthetic hormones, which showed the risks, but that's not the same as what we prescribe now, as you know. But loads of people keep saying, well, there's not enough evidence or they'll talk about any potential risks. Whereas antidepressants, it's very hard to find good evidence of that they improve mood in women who are menopausal because the studies haven't really been done but these studies that have aren't very good but we also know that antidepressants are associated with an increased risk of osteoporosis, inability to orgasm to also early dementia as well and addiction.

22:06So as a doctor my job really is to give people all the information or as much information as they need and want to make their decision about their treatment so I find it really weird that people have these unfounded fears about hormones and scared and reserved about prescribing hormone treatments that often patients want as well but then the antidepressants surely they have a duty to be telling people about the potential risks and side effects it feels weird I didn't even my mum had dementia and never you never even had that conversation and you know she didn't even say is that in the family because she would know the link yes of course and it was just no I think you're depressed and here's a prescription yeah I knew I wasn't depressed no no and you you just because you laughed I'm always laughing and giggling when I'm rowing it's my happy place yeah so you wouldn't have that no of course no not at all and um I I one of the questions we use on our symptom questionnaire which we use in the clinic but it's also on balance app is um people's what do you not feel like yourself yeah you go and a lot of people it's a very when women you either get it or you don't unless you've been there you don't really know but it's a very subtle thing and it's very hard if you're doing research to really quantify it and that's one of the problems really when they've done research on flushes and sweats you can see if someone's having a flush or a sweat but if i you know trying to assess does someone really feel like themselves it's quite it's quite vague but you know within yourself you know that you know that you've got a hormone imbalance and you know something's not right and and you're right you know it's not until you have those hormones back like you that you say you don't know what it's like to be missing something until you really have it back but it's incredibly frustrating to watch and witness so many women not reaching their full potential or not doing things and that your ethos with the rowing is to enable people to learn new activities, get out, get active.

24:10But you can see why so many people do become grannies and sit on the sofa knitting because it's exhausting, isn't it? It is exhausting. And, you know, I'm really clumsy, which I never used to be clumsy. I'm always walking into door handles, tripping over nothing on the floor. And I'm convinced it's just because my hormones aren't sorted yet. Yeah. Absolutely. And when you're weight training, and we need to weight train, you do work on Hover, don't drop this on myself. Because I am clumsy these days. The first time I went to the doctor and mentioned the word menopause, we lived in Wales. And my doctor at that time just prescribed me antidepressants.

24:54Oh, you're the same. And I remember... Did you take them? No, because I remember going for my last row without antidepressants. We lived in Conway at the time, so I was rowing underneath the bridge at Conway Castle. And I said to my husband, this is my last happy row. And he said, what do you mean? I said, well, I'm not depressed, but if I take antidepressants, they will take away the low, but they will also take away the high. So I will never enjoy a row again like this whilst I'm on my antidepressants. My husband just said, don't take them then. We'll find another solution.

25:37It's right. I mean, I've seen over these lots and lots of people on antidepressants. antidepressants and I wrote about it in my book actually just the story of a lady many years ago who I knew really well in general practice and you know I cringed because back then I didn't really know about hormones and looking back I'm sure she needed hormone treatments and I thought she was depressed and she was on antidepressants and she didn't know about hormones then either so it wasn't like I was refusing I just didn't think about it and she came in one day and she said oh I've just crashed the car and I said what did you do so I just misjudged the wall by my house and I just went into it.

26:09I said, gosh, are you okay? She said, yeah, no, I'm all right. I said, no, I think it's a write-off. I said, but you're, she goes, well, she said, I could have run over my best friend and it wouldn't bother me. So I've come to talk to you because I don't think I want these antidepressants anymore because they've made me so numb. And I thought, oh my gosh, this is real. You know, it's just, so she wasn't feeling as sad, but she had no joy at all. And she was completely living on a, just a flat space. And I made me then really stop and think about the harms of what I was doing and thinking about antidepressants differently.

26:41And since then, I've read a lot about the risks and the side effects and the harms of taking medication and actually their lack of effectiveness for many people as well. But it is this numbness that people get that really scares me, actually. And so not to feel joy is awful. Yeah. So there's a lot we need to do and i the other thing before i end i was just thinking you were saying how you were feeling a bit you know better when you were rowing out without and you didn't have your hormones then and some of it would have been because you weren't thinking about all the other things and and everything but also um just to remind people that listening our muscles are metabolically active and our muscles do produce hormones even our heart which is obviously a really important muscle makes estrogen.

27:30So are, you know, testosterone is made by muscles as well. And so, you know, when you're out doing that row, you must be so incredibly fit. And so it's interesting that, you know, your muscles, you're probably your hormone levels were a little bit higher than perhaps they are when you're not in the extreme sort of situation of racing and rowing. And so, you know, but the other thing is, is that to remind people is that it's not just about symptoms. It's about future health as well. So a lot of people say, well, I don't have symptoms, I don't need hormones. Well, we also prescribe them for future health to help, you know, hopefully reduce your risk of dementia in the future, heart disease, osteoporosis, and so forth.

28:14And so even if people have little or minimal symptoms, it's still really important to think about those hormones back. And you don't want to be a new norm. You don't want to be a a different person of yourself for the foreseeable future. And it's not fair on you or your children and your grandchildren. And you want to be this best version, don't you? Yes. And I think that's why we undertake things like we do now, the road to keep you mentally alive and mentally bright. But yeah, so you're doing one thing, but your hormones are letting you down on another. So it is getting it right. And that's the other thing that's so important because a lot of people, There's a lot on social media as well, where people think they can exercise their way and they will be fine.

28:59And it's a sort of form of gaslighting, really, I think. I find it really sad when people think that they can do all the sport they like and that will replace their hormones. Or I've heard some doctors say, if your patients are really fit and sporty and active, they won't get symptoms. And that's just, well, sadly, you've shown it here today. But, you know, it's true. We can't expect to replace our hormones enough just by exercise. But at the same time, you can't just take hormones and not exercise and not think about other ways to improve your future health. So having everything together is really important, as you're highlighting.

29:37It is a balance, yeah, most definitely. Absolutely. So hopefully in a few weeks and months, you'll be feeling a lot better with your hormones back. So you've got time for your hormones to be at the right dose and type before you do the... And that was one of the things for me because I'm losing training time. I'm very aware I'm losing training time from my previous year of training because I'm tired and I'm fuzzy and I'm not myself. And it was like I want to be that best version I was of myself on the start line as I was last time. And I felt I was letting the team down. And that's why I was like, hell, what do I do?

30:13And we've had some really good conversations, some really positives. And it's been really good. and it's nice to have somebody to chat to about it. And again, that whole thing is really important because it gives you the confidence then to see the right person, to get the right treatment and feel supported. And that's one of the reasons I set up Balance App was that there's a community where you're not alone and you can help each other. And women are good at helping each other, actually. So we need to carry on with that. So thank you so much for coming. Before I end, I usually ask for three take-home tips, but I'm going to have to do two each.

30:47so it'll have to be forward today. So I'm going to ask you the same things, but just for two for each of you. Two reasons why you should take up something new over the age of 50. Because setting a new challenge keeps you moving. Yeah. And that is so important when you get to 50 and beyond. For us, it means that we have a target. So we're doing all sorts of training. we're doing strength, we're doing aerobic, you know, we have to think about strategy as well. So it's keeping us both mentally and physically active. So definitely setting new targets and new challenges is my big go-to. And it doesn't matter how big or small it is, you just have to take that first step yeah excellent confidence build your confidence it makes you feel more alive I would say definitely and it also is good for your social side of things I think it introduces you to new people yeah and expands your social circles yeah expands conversations so that's mine absolutely yeah I mean the community that we are now part of the rowing community the ocean rowing community is such a supportive and social community it's just been wonderful well i hope they're all going to listen to this podcast and learn because they will either have hormone issues themselves or no people so the more we can share and learn it's better but thank you so much for coming and good luck with the row thank you for having us and if there are any sponsors out there that want to sponsor us and put your name on the boat brilliant so we'll put some notes in the show notes, some links so people can think about sponsorship too.

32:39But brilliant. Well done, both of you. Thank you. Thank you so much. So just a quick one. It'd be really great if you could follow or subscribe to this podcast. This will really help me reach more people with evidence-based information about hormones and their future health. And it also ensures that you'll never miss a future episode. Thank you.